Implementing a Virtual Reality Anatomical Model for Anterior Skull Base Surgical Education

Objective: There is limited application of virtual reality (VR) simulation in skull base anatomical and surgical education. We aim to assess the utility of a high-fidelity interactive three-dimensional (3D) VR model in improving knowledge of anterior skull base anatomy for residents and medical students. The secondary objective was to evaluate the feasibility of integrating VR models into surgical education curricula. Design: A multidisciplinary group of physicians, computer scientists, and anatomical illustrators contributed to a VR model targeting the surgical anatomy of the anterior skull base. Various patient’s CT scan data of the skull and vasculature was segmented using AMIRA and refined in ZBrush for anatomical accuracy, including skull base foramina. Models were meticulously aligned and retopologized to reduce total polygon count, optimizing them for VR. A prototype of the application was created in ShapesXR and finalized using Unity before being made available on the Meta Quest 3 headset. Study participants included residents in otolaryngology or neurosurgery programs and medical students enrolled in a skull base surgery course. Surveys were developed using an evidence-based 5-point Likert scale for use in clinical simulation research and implemented before and after use of the 3D VR model. Pre- and post-survey responses assessed participants’ perceptions of the VR application. In addition, a web-based interface with the same anatomical model was created for an objective knowledge assessment using 11 standardized anatomical structures. Participants completed pre- and post-VR simulation testing to assess their ability to identify anterior skull base anatomical structures. Results: Twenty-five participants completed the VR simulation, including 1 medical student and 24 otolaryngology and neurosurgery residents. Twenty-four participants completed the pre-survey (96%) and 20 participants completed the post-simulation survey (80%). Almost half of participants (45.8%) were 30-34 years old (n=11) and over one-third of participants (37.5%) were female (n=9). Nineteen participants had never or infrequently used a VR headset (79.2%). The average pre-simulation quiz score was 7.74 (70% correct score) and average post-simulation quiz score was 9.53 (87% correct score) (p